失匹配负波在抑郁症患者中的应用

目的探讨失匹配负波(MMN)在抑郁症患者中的应用价值.方法应用美国Nicolet Bravo脑诱发电位仪对53例抑郁症和50例正常成人进行了MMN检测.结果与正常对照组相比,抑郁症患者MMN潜伏期后移(正常对照组180.2±22.7ms,抑郁症组200.6±20.1ms,t=4.8,P＜0.01),波幅降低(正常对照组4.6±2.0μV,抑郁症组3.4±1.9μV,t=3.12,P＜0.01).结论 MMN技术可反映抑郁症患者诱发脑电的自动加工过程.MMN可作为抑郁症患者的临床应用检测指标.     

橄榄体脑桥小脑萎缩听觉P300认知电位的研究

目的 观察P300检查在橄榄体脑桥小脑萎缩中的应用价值及影响因素.方法 应用P300检查和认知能力筛选量表(CASI)对34例橄榄体脑桥小脑萎缩患者和与其年龄、性别相匹配的正常对照组进行检测.结果 患者不同年龄组P300潜伏期较对照组明显延长(t=2.682～4.983,P<0.05～0.01),患者不同年龄组CASI评分比正常对照组明显降低(t=2.486～5.241,P<0.01),患者组P300潜伏期与CASI评分之间呈负相关(r=-0.48,P<0.005),病情轻组[(348.68±21.47) ms]与重组[(363.27±30.15) ms]和脑萎缩明显组[(354.46±26.98) ms]与不明显组[(338.74±23.56) ms]之间P300潜伏期均差异有显著意义 (P<0.01).结论 评价橄榄体脑桥小脑萎缩的认知功能状态,P300检查是一项有价值的客观指标,其异常程度与病情轻、重和脑萎缩程度有关.     

慢性酒中毒患者脑诱发电位失匹配性负波的变化

目的　观察慢性酒中毒患者 (chronicalcoholics,CA)失匹配性负波 (MMN)的特点。方法　应用美国NicoletSpirit脑电生理仪 ,对 30例慢性酒中毒患者 (CA)、2 9名正常人 (NC组 )的MMN作了检测。结果　与正常对照组比较 ,慢性酒中毒患者MMN潜伏期延迟 (NC :16 2 .5 5± 14 .6 1ms,CA :2 4 6 .17± 18.5 1ms ;t=- 19.2 2 ,P <0 .0 1) ,波幅降低 (NC :5 .0 6± 1.13μV ,CA :2 .0 9± 0 .88μV ;t =11.2 9,P <0 .0 1)。结论　慢性酒中毒患者大脑的自动加工过程有异常 ,可以通过MMN技术反映出来。MMN可以作为CA的检测指标之一。     

强迫症患者的失匹配负波研究

目的 探讨强迫症患者失匹配负波(MMN)的特点.方法 应用美国Nicolet Bravo脑诱发电位仪,对27例强迫症患者和33名正常成人进行了MMN检测.结果 与正常对照组相比,强迫症患者MMN潜伏期延迟(正常组(191±23)ms,强迫症组(208±25)ms,t=2.793,P＜0.01),同时波幅降低(正常组(8.9±1.7)μV,强迫症组(5.4±1.9)μV,t=6.24, P＜0.01).结论 被动事件相关电位MMN可反映强迫症患者自动加工过程.失匹配负波在评价强迫症脑功能失常上可能是有用的指标.     

孤独症患儿失匹配负波实验研究

目的 探讨孤独症患儿失匹配负波(MMN)的特点.方法 应用美国Nicolet Bravo脑诱发电位仪对37例孤独症和30例正常儿童进行了MMN检测.结果 与正常儿童组相比,孤独症患儿MMN潜伏期后移,正常儿童组(178.7±21.7)ms,孤独症组(197.1±19.1)ms,t=3.64,P＜0.01;波幅降低,正常儿童组(4.9±1.5)μV,孤独症组(3.3±1.8)μV,t=3.84, P＜0.01.结论 MMN对临床辅助诊断孤独症有一定参考价值.     

酒依赖相关精神障碍患者的脑干听觉反应及P300异常变化

目的探讨酒依赖患者脑干听觉反应(ABR)及P300的特点.方法以click短声、听觉靶刺激和非靶刺激为诱发事件,检测26例男性酒依赖患者及31名男性正常人的ABR和事件相关电位P300.结果 (1)ABR与对照组比较,酒依赖组波Ⅱ～波Ⅶ的绝对潜伏期长,波Ⅱ～波Ⅴ的绝对波幅低,差异均有显著性和非常显著性(P<0.05或P<0.01);(2)P300在靶刺激中,酒依赖组的P2和P3潜伏期[分别为(187±26)ms和(319±27)ms]长于对照组[分别为(171±21)ms和(302±16)ms],P2和P3波幅[分别为(3.9±2.3)μV和(3.5±3.1)μV]低于对照组[分别为(6.0±2.1)μV和(8.2±4.1)μV];在非靶刺激中,酒依赖组的N1潜伏期[(108±14)ms]长于对照组[(98±12)ms];差异有显著性和非常显著性(P<0.05或P<0.01).结论长期大量饮酒不仅损害脑干功能,同时损害皮层认知功能.     

抑郁障碍的P300及非匹配负波实验研究

目的 建立非匹配负波(MMN)并探讨抑郁障碍的特点.方法 应用美国Nicolet Bravo脑诱发电位仪,对35例抑郁障碍和32名正常成人进行了P300和MMN检测.结果 与正常对照组相比,抑郁障碍MMN潜伏期延迟(正常组:(190±21)ms,抑郁障碍(267±27)ms,t=12.94,P<0.01),同时波幅降低(正常组(8.3±1.4)μV,抑郁障碍组(5.1±2.0)μV,t=7.52, P<0.01).结论 非匹配负波新技术可反映抑抑郁障碍及其他精神障碍诱发脑电波的自动加工过程,可推广于临床应用.     

非匹配负波对遗忘型轻度认知障碍诊断和预后的价值

Objective To evaluate the value of event-related potential mismatch negativity(ERP-MMN)for diagnosis and prognosis of amnestic mild cognitive impairment(aMCI).Methods 181 people were enrolled in this study,including 102 aMCI patients and 79 normal people and all of them underwent the clinical symptom and performance of neuropsychologieal measures and cranium imaging and examination of MMN.aMCI patients were judged to progress to Alzheimer's disease(AD)or not by clinical symptom and performance of neuropsychological measures during 1 year follow-up period.Through analysis of peak latency (PL)and amplitude(Amp),the value of MMN in diagnosis of aMCI and normal subjects was assessed,judging aMCI progress to AD or not.Results In contrast to normal control subjects(NC),PL of MMN in subjects of aMCl was significantly longer and Amp was significantly shorter,PL of MMN(312.7±25.7)ms vs(285.1±28.8)ms(t=6.81,P<0.01),Amp(3.5 ±1.3)μV vs(4.7±1.1)μV(t=-6.37,P<0.01).Moreover,PL of MMN in subjects of aMCl which would progress to AD was significantly longer than of subjects of aMCI which would not progress,(332.2±24.1)ms vs(307.5 ±24.0)ms(t=2.75,P=0.007).However.significantly difference was not observed in Amp of MMN and neuropsychological measures between subjects of aMCI would progress and not.Conclusions MMN can be used in auxiliary diagnosis and judging prognosis of aMCI.It is appropriate when is required to reflect and monitor periodic cognitive state of subjects of aMCI.     

非匹配负波对遗忘型轻度认知障碍诊断和预后的价值

Objective To evaluate the value of event-related potential mismatch negativity(ERP-MMN)for diagnosis and prognosis of amnestic mild cognitive impairment(aMCI).Methods 181 people were enrolled in this study,including 102 aMCI patients and 79 normal people and all of them underwent the clinical symptom and performance of neuropsychologieal measures and cranium imaging and examination of MMN.aMCI patients were judged to progress to Alzheimer's disease(AD)or not by clinical symptom and performance of neuropsychological measures during 1 year follow-up period.Through analysis of peak latency (PL)and amplitude(Amp),the value of MMN in diagnosis of aMCI and normal subjects was assessed,judging aMCI progress to AD or not.Results In contrast to normal control subjects(NC),PL of MMN in subjects of aMCl was significantly longer and Amp was significantly shorter,PL of MMN(312.7±25.7)ms vs(285.1±28.8)ms(t=6.81,P<0.01),Amp(3.5 ±1.3)μV vs(4.7±1.1)μV(t=-6.37,P<0.01).Moreover,PL of MMN in subjects of aMCl which would progress to AD was significantly longer than of subjects of aMCI which would not progress,(332.2±24.1)ms vs(307.5 ±24.0)ms(t=2.75,P=0.007).However.significantly difference was not observed in Amp of MMN and neuropsychological measures between subjects of aMCI would progress and not.Conclusions MMN can be used in auxiliary diagnosis and judging prognosis of aMCI.It is appropriate when is required to reflect and monitor periodic cognitive state of subjects of aMCI.     

强迫症患者的事件相关脑电位实验研究

背景 强迫症在辅助诊断上目前还缺乏客观的实验室依据。近年来国内外对强迫症的事件相关脑电位进行了研究,结果并不一致。分析其主要原因与所使用仪器、技术性能有关。为此本研究使用国际标准化的美国Nicolet脑电生理仪,并以较成熟的关联性负变、P300及失匹性负波3种事件相关脑电位为手段,并设临床上较多见的抑郁症和广泛性焦虑症为疾病对照,进一步探讨强迫症的脑电生理机制,为临床诊断及治疗提供参考依据。 方法 应用美国Nicolet Spirit 脑诱发电位仪,采用光和声成对刺激以及“听觉靶-非靶刺激序列”技术,对38例强迫症、20例抑郁症和18例广泛性焦虑症及28名正常人的关联性负变(CNV)、P300及失匹性负波(MMN)作了检测。3组疾病组病例均选自2002年5月至2005年12月上海市精神卫生中心,经2名以上的高年资医师确诊并符合中国精神障碍分类方案第三版（CCMD-3）中的强迫症和抑郁症及广泛性焦虑症诊断标准;听力均正常,并无躯体疾病或其他精神疾病,均为右利手。3组对象均未使用过精神科药物。结果 ①CNV：M1波幅抑郁症组[(5±4)μV]和广泛性焦虑症组[(7±4)μV]低于正常组[(14±6)μV]和强迫症组(16±6)μV,指令信号后负变化的出现率抑郁症组(60%)、强迫症组(45%)和广泛性焦虑症组(35%)均高于正常组(4%),上述组间差异均有统计学意义（P<0.05或P<0.01）。②P300：在靶刺激中,N2潜伏期在4组间的差异有统计学差异(P<0.01),其中强迫症组[(276±22)ms]和抑郁症组[(277±22)ms]的潜伏期均长于正常组[(259±14)ms],广泛性焦虑症组短于抑郁症组和强迫症组(P<0.01);P3波幅在4组间的差异亦有统计学差异(P<0.01),其中强迫症组[(3.4士1.6)μV]、抑郁症组[(2.9±1.3)μV]和广泛性焦虑症组[(3.3士1.3)μV]均低于正常组[(5.9土2.1)μV]。在非靶刺激中,广泛性焦虑症组P2波幅低于强迫症组和正常组(P<0.05)。③MMN：强迫症组、抑郁症组及正常组之间潜伏期和波幅的差异有统计学差异(P<0.05或P<0.01)。其中强迫症组和抑郁症组的潜伏期长于正常组(P<0.05);强迫症组的波幅高于正常组(P<0.05),抑郁症组的波幅低于正常组(P<0.05)和强迫症组(P<0.01)。结论 ERPs波幅一高一低变异特点可能对鉴别强迫症和抑郁症有参考意义。